Twenty years ago, Muluken Melese was the only doctor serving thousands of residents at a rural health facility in southern Ethiopia. The community’s poverty and health system weaknesses made this position particularly challenging. Over time, the young doctor realized that the great majority of his patients’ illnesses could be prevented through community education or easily treated under a strengthened health system. This awareness piqued Muluken’s interest in public health and, after two years as a physician, he began pursuing other professional opportunities to supplement his clinical experience.
Recognizing his passion and skill, ActionAID invited Muluken to work as a project health manager and, later, the World Health Organization hired to him support the Ministry of Health in developing emergency health systems and addressing gender-based violence. He also served as the deputy country director for ORBIS International and as a program director at Columbia University’s International Center for AIDS Care and Treatment Programs. In these positions, Muluken coordinated health services, trained health workers, and led community-based water and sanitation projects. Muluken’s medical expertise and public health experience also gave him a unique perspective on the Ethiopian health care system and equipped him to publish over 30 journal articles on TB, HIV, and blindness.
Six years ago, learning of Muluken’s leadership experience and clinical expertise, Management Sciences for Health (MSH) asked him to serve as the technical director for the HIV/AIDS Care and Support (HCSP) project. USAID’s HCSP was one of the largest projects in Africa working to decentralize HIV & AIDS care and treatment services to the health center level. Muluken’s success in this position inspired MSH to promote and, in 2011, he had accepted his current position as project director for the USAID funded-project, Help Ethiopia Address Low Tuberculosis (HEAL TB). Today, just half way through the project’s five-year lifespan, Muluken’s expert leadership has made HEAL TB a thriving and successful health project reaching thousands of residents in 21 zones of Ethiopia. Hardworking, yet humble, Muluken attributes this success to his dedicated project team and committed stakeholders at all levels of the health system.
“We have great support from USAID, not only financially but also technically. The government is also supportive – they feel as we are one of their team. You know – they don’t consider us as an outsider – if something fails we’re also responsible. We are involved in the planning, implementing, decision making, and evaluation. The Ministry… considers us their own team. We’re not creating a parallel structure, we’re working in the existing system.”
For Muluken, these partnerships go beyond contractual agreements to include regular, transparent communication, and collaborative work planning.
“Before we develop our work plan, we discuss it with the ministry and the regions to determine what they need. It’s open—we share. I know what they have, they know what we have, so we don’t overlap.”
Muluken’s management strategies have allowed HEAL TB to effectively navigate the political context, while his clinical experience has guided the project’s technical strategy.
“Capacity building and community mobilization have allowed us to bring hundreds of TB patients to treatment. We also focus on helping these patients access proper treatment and adhere to their medications. If you do all of this, it reduces TB transmission and incidence. Furthermore, by building health extension workers’ capacity, we can reach neglected segments of the community, such as mothers, children, and the elderly.”
Muluken’s strong leadership experience is helping to improve TB control in Ethiopia and has equipped him to provide mentorship support to MSH’s other TB projects, such as USAID’s TRACK TB Activity project in Uganda. As an experienced physician and public health professional, Muluken’s work is also impacting the global health community at large. At this year’s Union World Lung Health Conference, for example, Muluken and the HEAL TB team presented five posters and one oral presentation showcasing the project’s results. This year, the team also published three journal articles detailing HEAL TB’s strategic approach to TB control and significant project results.
“Research and advocacy influence health systems… we should use our experiences to improve health-related policies and interventions at national and international levels. It’s the way you sell it – we don’t do it for conferences, we do it to address the gaps, to improve project implementation.”
For more information of HEAL TB’s work, please view their conference posters and the following journal articles:
- Predictors of mortality among TB-HIV co-infected patients being treated for TB in Northwest Ethiopia: a retrospective cohort study
- Determinants of multidrug resistant (MDR-TB) TB patients who underwent first-line treatment in Addis Ababa
- Determinant factors associated with occurrence of TB among adult people living with HIV after antiretroviral treatment initiation in Addis Ababa, Ethiopia: a case control study